Provider Demographics
NPI:1649753443
Name:MOFFETT, BARBARA (PT,MS)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:MOFFETT
Suffix:
Gender:F
Credentials:PT,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 OVILLA OAKS DR
Mailing Address - Street 2:
Mailing Address - City:OVILLA
Mailing Address - State:TX
Mailing Address - Zip Code:75154-5641
Mailing Address - Country:US
Mailing Address - Phone:214-533-3184
Mailing Address - Fax:
Practice Address - Street 1:805 OVILLA OAKS DR
Practice Address - Street 2:
Practice Address - City:OVILLA
Practice Address - State:TX
Practice Address - Zip Code:75154-5641
Practice Address - Country:US
Practice Address - Phone:214-533-3184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-08
Last Update Date:2018-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy